Complications of Central Venous Totally Implantable Access Port: Internal Jugular Versus Subclavian Access

• DOI: 10.4266/kjccm.2015.30.4.365
• Publication Date: 2015-12-15T20:42:17Z
• Authors: Pil Young Jung; Hoon Ryu; Jae Hung Jung; Eunbi Lee; Joong Hwan Oh; Chun Sung Byun; Il Hwan Park
• Keywords: 03 medical and health sciences; 0302 clinical medicine; RC86-88.9; subclavian vein; vascular access; Medical emergencies. Critical care. Intensive care. First aid; vascular access devices; jugular vein; 3. Good health

Background: Totally implantable access port (TIAP) provides reliable, long term vascular access with minimal risk of infection and allows patients normal physical activity. With wide use of ports, new complications have been encountered. We analyzed TIAP related complications and evaluated the outcomes of two different percutaneous routes of access to superior vena cava. Methods: All 172 patients who underwent port insertion with internal jugular approach (Group 1, n = 92) and subclavian approach (Group 2, n = 79) between August 2011 and May 2013 in a single center were analyzed, retrospectively. Medical records were analyzed to compare the outcomes and the occurrence of port related complications between two different percutaneous routes of access to superior vena cava. Results: Median follow-up for TIAP was 278 days (range, 1-1868). Twenty four complications were occurred (14.0%), including pneumothorax (n = 1, 0.6%), migration/malposition (n = 4, 2.3%), pinch-off syndrome (n = 4, 2.3%), malfunction (n = 2, 1.1%), infection (n = 8, 4.7%), and venous thrombosis (n = 5, 2.9%). The overall incidence was 8.7% and 20.3% in each group (p = 0.030). Mechanical complications except infectious and thrombotic complications were more often occurred in group 2 (p = 0.033). The mechanical complication free probability is significantly higher in group 1 (p = 0.040). Conclusions: We suggest that the jugular access should be chosen in patients who need long term catheterization because of high incidence of mechanical complication, such as pinch-off syndrome.